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Gastrointestinal > Brain To Gut, Gut To Brain Signalling > Flashcards

Brain To Gut, Gut To Brain Signalling Flashcards

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1
Q

What is the role of afferent neurones?

A

Signal from gut to brain

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2
Q

What is the role of efferent neurones?

A

Signal from brain to gut

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3
Q

What are the autonomic neurones of GI tract?

A

Vagal (parasympathetic) efferents - act via enteric neurones

Sympathetic efferents - act on blood vessels and enteric neurones

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4
Q

What do enteric neurones do?

A

Control motility, secretion, blood flow, mucosal growth

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5
Q

What does gastric distension stimulate?

A

Mechanoreceptors

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6
Q

What do intestinal nutrients stimulate?

A

Hormone, paracrine mediators

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7
Q

What is secreted in the inter digestive period?

A

Ghrelin

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8
Q

What do the mechanoreceptors and nutrients and paracrine mediators stimulate?

A

Vagal afferents to brain

Out of brain vagal efferents

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9
Q

What is stimulated down the vagal efferents?

A

Decrease gastric emptying
Increase pancreatic secretion
Increase gastric secretion
Increase gut immune responses

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10
Q

What are the 3 phases of gastric acid secretion?

A

Cephalic, gastric, intestinal

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11
Q

What happens in cephalic phase?

A

Release of acetylcholine and gastric releasing peptide

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12
Q

What happens in the gastric phase?

A

Release of gastrin

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13
Q

What happens in intestinal phase?

A

Release of inhibitory factors

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14
Q

What is the role of the greater T5-T9 splanchnic nerves?

A

Ganglion - celiac
Viscera - foregut
Region of referred pain - epigastric

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15
Q

What is the role of the lesser T10/T11 splanchnic nerves?

A

Ganglion - superior mesenteric
Viscera - midgut
Region of referred pain - periumbilical

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16
Q

What is the role of the least T12 splanchnic nerves?

A

Ganglion - aortico-renal
Viscera - kidneys
Region of referred pain - lower thoracic

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17
Q

What is the role of the lumbar L1/L2 splanchnic nerves?

A

Ganglion - inferior mesenteric
Viscera - hindgut
Region of referred pain - hypogastric

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18
Q

What are 2 types of nociception?

A

Hyperalgesia and allodynia

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19
Q

What is hyperalgesia?

A

Increased response to painful stimulus

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20
Q

What is allodynia?

A

Painful response to a normal innocuous stimulus

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21
Q

What are 2 types of acid peptic related pain?

A

Heartburn and peptic ulcer

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22
Q

What is heartburn?

A

Reflux of acid into oesophagus

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23
Q

What is distension?

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A

Mechanoreceptor responses to stretch above ‘threshold’

24
Q

What is satiety?

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A

Fullness that persists after eating

25
What is satiation?
Prompts the termination of eating
26
What controls food intake?
Satiation - amount consumed at one sitting | Satiety - length of time until next occasion
27
What are enteroendocrine cells?
Largest endocrine organ in body Approx 12 cell types Many respond to nutrients
28
What are nodose ganglion?
Vagal afferent neurones Express receptors for many gut hormones Receptors transported from cell soma to peripheral
29
What kind of receptors are there in nodose ganglion?
CCK receptors
30
Where is GLP-1 released?
L-cells
31
What increases / suppresses GLP-1 secretion?
Increase in macronutrients Increase in bariatric surgery Decrease somatostatin Decrease calorie restriction
32
What is the GLP-1 receptor?
GLP-1R
33
What is the site of action from GLP-1 thought to mediate effects on food intake?
Vagus; brainstem; hypothalamus
34
What is the role of GLP-1 in body weight regulation?
Increases satiation and satiety, potentiates insulin release
35
Where is ghrelin released?
Gastric mucosa
36
What increases / suppresses ghrelin secretion?
Circadian rhythms ; | Increase by lack of sleep, increase by calorie restriction, decrease by macronutrients, decrease by bariatric surgery
37
What is the ghrelin receptor?
GHS-R1a
38
What is the site of action of ghrelin thought to mediate effects on food intake?
Vagus; brainstem; hypothalamus
39
What is the role of ghrelin in body weight regulation?
Meal initiator; long term regulator of body weight
40
Where is CCK released?
Proximal small intestine I cells
41
What factors increase or suppress secretion of CCK?
Increased by fat and protein rich chyme, increased by coffee, decreased by bile acids
42
What is the CCK receptor?
CCK1
43
What is the site of action of CCK thought to mediate effects on food intake?
Vagus; brainstem; hypothalamus
44
What is the role of CCK in body weight regulation?
Increases satiation
45
What is the role of cck?
Regulator of small intestine digestion and integrator of brain and gut function
46
What does CCK stimulate?
Pancreatic enzyme secretion, gall bladder contraction ( for release of bile into SI to digest lipids )
47
What does CCK inhibit?
Inhibits foo intake and gastric emptying, via vagal afferent neurons ( thereby delaying nutrient delivery to small intestine )
48
What happens to vagal afferent neurons during obesity?
Insensitive to CCK so does not inhibit food intake and gastric emptying
49
What is the role of GLP-1?
Regulator of nutrient utilisation, integrator of brain and gut function
50
What does GLP-1 stimulate?
Insulin secretion
51
What does GLP-1 inhibit?
Inhibits food intake and gastric emptying, via vagal afferent neurons (thereby delaying nutrient delivery to small intestine)
52
What occurs during GLP-1 based therapy?
DPV-IV inhibitors delay GLP-1 breakdown, GLP-1 analogues mimic the effect of GLP-1
53
What is the role of ghrelin?
Stimulator of nutrient intake, integrator of gut and brain function
54
When is secretion of ghrelin highest?
Highest in blood immediately before a meal
55
What does ghrelin stimulate?
Food intake and gastric emptying
56
Where are ghrelin receptors expressed?
Expressed on vagal afferent and hypothalamic neurones
57
What does ghrelin inhibit?
Actions of CCK on vagal afferent neurones

Gastrointestinal (11 decks)

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